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Flashcards in 3/3 Deck (56):
1

Why does SIADH present with euvolemic hyponatremia?

The excess ADH leads to water reabsorption, leads to RAAS activation, leads to natriuresis, leading to normalized volume with low sodium

2

In assessing viral HBV infection, what viral process does HBeAg indicate?

HBeAg = viral replication, increased infectivity

Indicates increased risk of neonatal infx if seen in mother

3

In homocystinuria, what AA becomes essential?

Cysteine

4

What are common sx of homocystinuria?

Hypercoagulability
Premature atherosclerosis
Ectopia lentis (displacement of ocular lens)
Osteoporosis
Mental retardation

5

Warfarin MoA?

Inhibits vit K dependent carboxylation of glutamic acid residues in factors 1972CS

6

CGD patients are susceptible to infection by what type of bugs?

Bacterial and fungal infections that are CATALASE POSITIVE

(Staph. aureaus, Burholderia cepacia, Serratia marcescens, Nocardia, Aspergillus)

7

What are some common catalase positive bugs?

Staph aureus, burkholderia cepacia, Serratia marscencens, Nocardial, Aspergillus

8

Tx for trichomonas vaginitis and bacterial vaginosis (Gardnerella)?

Metronidazole
(Disulfram-like rxn)

9

Tx for chlamydial urethritis?

Doxycycline or azithromycin

10

Tx for candida vaginitis?

Fluconazole

11

Niacin (vit B3) MoA in treating hyperlipidemia?

Decreasing synthesis of TG and VLDL

Also increases HDL by 25-30%, best one!

12

Prominent side effect of niacin?

Flushing

13

Bile acid binding resins effect on TG?

Increase

14

Ezetimibe MoA?

Decrease intestinal absorption of cholesterol

15

What drug reduces tobacco withdrawal cravings and attenuates rewarding effects of nicotine?

Varenicline

Partial agonist of nicotinic ACh-Rs

16

Selective COX2 inhibitor?

Celecoxib

17

Celecoxib MoA?

Selective COX2 inhibitor

18

When is celecoxib (selective COX2 inhibitor) useful?

To avoid platelet aggregation impairment

19

Diphenoxylate MoA?

Binds to mu opiate receptors to slow GI motility

(Opiate)

20

What to give for secretory diarrhea?

Octreotide

21

What nerve for foot dorseiflexion? Plantar flexion?

Dorsiflexion: Common peroneal

Plantar flexion: Tibial

22

Incomplete obliteration of the processus vaginalis can lead to what two similar pathologies?

Hydrocele (small opening remains)

Indirect inguinal hernia (large opening remains)

23

What is the single most important risk factor in development of intimal tears leading to aortic dissection?

HTN

24

What congenital disease is associated with aortic dissection?

Marfan syndrome (esp in younger pts)

25

The most common cause of death from TCAs?

Arrhythmias from inhibition of Na channel conduction

26

Rule of 2s for Meckel's diverticulum?

2% of population
2 feet from ileocecal valve
2 inches in length
2% are symptomatic
2 times as likely in males

27

Wernicke's syndrome triad?

Opthalmoplegia, ataxia, confusion

28

In Wernicke's syndrome, where do you find hemorrhage and necrosis in the brain?

Mamillary bodies and periaqueductal gray matter

29

What causes Wernicke's syndrome?

Chronic thiamine (B1) deficiency

30

Thiamine (B1) is a cofactor for which enzymes?

1. Pyruvate dehydrogenase
2. alpha-ketoglutarate dehydrogenase
3. Transketolase

31

Ankylosing spondylitis is a chronic inflammatory disorder of what?

Sacroiliac joints and axial skeleton

32

"Bamboo spine" on xray describes what disease?

Ankylosing spondylitis

33

What are the seronegative (lacking serum rheumatoid factor) spondyloarthropathies?

Ankylosing spondylitis
Reactive arthritis
IBD associated arthritis
Psoriatic arthritis

(Associated with HLA B27)

34

The portal triad that runs through the hepatoduodenal ligament contains what vessels?

Hepatic artery
Portal vein
Common bile duct

35

Where are S cells (secretin releasing) located?

Duodenum

36

Secretin causes release of bicarb from what organ?

Exocrine pancreas

37

Pancreatic juice normally has the same [Na] and [K] as plasma. Is the [HCO3] and [Cl] higher or lower? How do they change with flow rate?

[HCO3] is higher than plasma, and goes higher with higher flow rate.

[Cl] is lower than plasma and goes lower with higher flow rate.

38

Digoxin MoA

Inhibits Na/K pump, increases intracellular [Na], reducing Ca efflux, increasing intracellular [Ca]

This decreases conductivity through AV node and increases contractility of myocyte

39

Familial chylomicronemia is an AR condition cause by deficiency of what enzyme? What is the common presenting disease?

Lipoprotein lipase deficiency, presenting in childhood with recurrent acute pancreatitis

40

Which virus, HBV or HCV, persists in the host genome to continue risk of HCC?

HBV, a DNA virus, injects into host chromosome, allowing transcription of HBx protein.

HBx inactivates p53.

41

Systolic crescendo decrescendo murmur

Aortic stenosis

42

Malaria tx?

Chloroquine if sensitive, mefloquine if chloroquine -resistant

43

Pantothenic acid (coenzyme A) is particularly important for which step of the TCA?

First step: oxaloacetate to citrate

44

Multiple ring-enhancing lesions on contrast MRI in an HIV pt points to what bug?

Toxoplasmosis

45

Aplastic anemia pathogenesis?

BM failure due to deficiency in CD34 hematopoietic stem cells

46

Causes of aplastic anemia?

Autoimmune
Infections (parvovirus B19, EBV)
Drugs (carbamazepine, chloramphenicol, sulfonamides)
Radiation/toxins (benzene, solvents)

47

PABA blocks what type of UV rays?

UVB (the Bad one)

48

What drug gives red/orange discoloration to secretions (urine, breast milk, tears)?

Rifampin

'rifAMPin AMPlifies' CYP450
Used for Neisseria meningitidis prophylaxis

49

What is the precursor for serotonin?

Tryptophan

50

What is tyrosine the precursor for?

Dopamine, NE, Epi, melanin, thyroxine

51

What is the antidote for serotonin syndrome?

Cyproheptadine, first gen histamine antagonist with nonspecific 5HT-R anatgonism

52

Slowly growing jaw mass in setting of oral trauma, that drains yellow pus through the skin = what bug?

Actinomyces

Normal gram+ oral flora
Tx: penicillin and debridement

53

Borrelia burgdorferi causes what disease?

Lyme disease

54

Pasteurella multocida is associated with what type of injury?

Animal (usually cat) bites

55

What is the disease and cutaneous lesion associated with Rickettsia?

Rocky Mtn Spotted Fever, with palmoplantar erythematous macules that migrate centrally

56

What 2 drugs are given to diabetics to decrease progression of diabetic nephropathy?

ACE-I and ARB
(Lisinopril)